Vasectomy

The surgical object of vas deferens anastomosis is mainly for the need for anastomosis after the vasectomy and the need for re-fertility and vas deferens accidental injury. When surgery, it is necessary to pay attention to the separation of the vas deferens. It should not be separated too long or too short. Too long will hinder the blood supply of the vas deferens. If it is too short, it will be affected by the tension and is not conducive to healing. Care should be taken to avoid damage to the testicular arteries when separating the vas deferens. When the stent wire is inserted into the vas deferens, it should be sutured to the skin with silk thread in time to avoid accidental pulling out during surgery. Treatment of diseases: lack of vas deferens Indication 1. Those who need to give birth after the vasectomy is ligated. 2. Accidental injury to the vas deferens requires anastomosis. Preoperative preparation For local skin preparation, the perineum should be washed once a day on the 2nd day before surgery. Surgical procedure 1. Position: supine position, the two lower limbs are slightly separated. 2. Incision, separation of the vas deferens: the skin scar of the vasectomy is removed, the incision is enlarged to 2 ~ 3cm, the distal and proximal ends of the vas deferens are separated clearly, and the ends are lifted with sutures. Then, the vas deferens are separated to the ends, and the anastomosis after the stump is removed without tension. It is not advisable to separate too much, so as not to affect the blood supply of the vas deferens. Excision of the distal and proximal stump scars. 3. Introduce the stent wire into one end of the vas deferens: insert the lumen from the proximal end of the vas deferens with a 7-8 needle, and pass through the wall 1.5 cm away from the broken end, and pass through the skin of the scrotum. The nylon thread is introduced into the needle cavity, the needle is withdrawn, the nylon thread is left in the lumen, the end is exposed on the outside of the skin, and the skin end is sutured to the skin with a silk thread. 4. Insert the stent wire into the lumen of the other end of the vas deferens: insert the other end of the nylon thread upward into the distal vas deferens lumen 4 to 5 cm, and use it as a lumen stent. 5. Anastomotic vas deferens: 3~4 needles were sutured with 7-0 nylon thread or 5-0 silk thread for end-to-end anastomosis. 6. Reduction of vas deferens: suture the tissue around the vas deferens with silk thread, usually only 2 to 3 needles to cover the vas deferens, and then suture the skin incision.

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